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131.
Ana V. Nikčević Gabriele Caselli Deborah Green Marcantonio M. Spada 《Journal of Rational-Emotive & Cognitive-Behavior Therapy》2014,32(4):248-256
Both perceived stress and negative recurrent thinking (rumination and worry) have been associated with depressive symptoms. However, no research to date has investigated the association between perceived stress and negative recurrent thinking. In the present study we aimed to explore whether perceived stress and negative recurrent thinking are associated and whether negative recurrent thinking moderates the relationship between perceived stress and depressive symptoms. A convenience sample of 273 undergraduate students completed the Perceived Stress Scale, the Ruminative Responses Scale-10, the Penn State Worry Questionnaire and the Hospital Anxiety and Depression Scale 2 weeks prior to sitting mid-year examinations. Correlation analyses showed that perceived stress, rumination and worry were positively and significantly associated with depressive symptoms and that perceived stress was positively and significantly associated with rumination and worry. A moderation analysis confirmed that negative recurrent thinking moderated the relationship between perceived stress and depressive symptoms. The implications of these findings are discussed. 相似文献
132.
Patterns of coordination result from the interaction between (at least) two oscillatory components. This interaction is typically understood by means of two variables: the mode that expresses the shape of the interaction, and the stability that is the robustness of the interaction in this mode. A potent method of investigating coordinated behaviors is to examine the extent to which patterns of coordination arise spontaneously. However, a prominent issue faced by researchers is that, to date, no standard methods exist to fairly assess the stability of spontaneous coordination. In the present study, we introduce a new method called the index-of-stability (IS) analysis. We developed this method from the phase-coupling (PC) analysis that has been traditionally used for examining locomotion–respiration coordinated systems. We compared the extents to which both methods estimate the stability of simulated coordinated behaviors. Computer-generated time series were used to simulate the coordination of two rhythmic components according to a selected mode m:n and a selected degree of stability. The IS analysis was superior to the PC analysis in estimating the stability of spontaneous coordinated behaviors, in three ways: First, the estimation of stability itself was found to be more accurate and more reliable with the IS analysis. Second, the IS analysis is not constrained by the limitations of the PC analysis. Third and last, the IS analysis offers more flexibility, and so can be adapted according to the user’s needs. 相似文献
133.
Patricia Benner Jodi Halpern Deborah R. Gordon Catherine Long Popell Patricia W. Kelley 《The Journal of medical humanities》2018,39(1):45-72
An alternative to objectifying approaches to understanding Post-traumatic Stress Disorder (PTSD) grounded in hermeneutic phenomenology is presented. Nurses who provided care for soldiers injured in the Iraq and Afghanistan wars, and sixty-seven wounded male servicemen in the rehabilitation phase of their recovery were interviewed. PTSD is the one major psychiatric diagnosis where social causation is established, yet PTSD is predominantly viewed in terms of the usual neuro-physiological causal models with traumatic social events viewed as pathogens with dose related effects. Biologic models of causation are applied reductively to both predisposing personal vulnerabilities and strengths that prevent PTSD, such as resiliency. However, framing PTSD as an objective disease state separates it from narrative historical details of the trauma. Personal stories and cultural meanings of the traumatic events are seen as epiphenomenal, unrelated to the understanding of, and ultimately, the therapeutic treatment of PTSD. Most wounded service members described classic symptoms of PTSD: flashbacks, insomnia, anxiety etc. All experienced disturbance in their sense of time and place. Rather than see the occurrence of these symptoms as decontextualized mechanistic reverberations of war, we consider how these symptoms meaningfully reflect actual war experiences and sense of displacement experienced by service members. 相似文献
134.
Katie A. Ragsdale Michael A. Gramlich Deborah C. Beidel Sandra M. Neer Emily G. Kitsmiller Krystal I. Morrison 《Behavior Therapy》2018,49(4):617-630
Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history. 相似文献
135.
Mick Cooper Claudia-Martina Messow Alex McConnachie Elizabeth Freire Robert Elliott Deborah Heard 《Counselling psychology quarterly》2018,31(4):460-476
The aim of this analysis was to explore whether pre-treatment intervention preferences were related to outcomes for patients with persistent sub-threshold and mild depression who received one of two treatment types. Thirty-six patients took part in a two-arm, parallel group, pilot randomized controlled trial that compared short term (3 month and 6 month) outcomes of person-centred counselling (PCC) compared with low-intensity, CBT-based guided self-help (LICBT). Patient preferences for the two interventions were assessed at baseline assessment, and analysed as two independent linear variables (pro-PCC, pro-LICBT). Eight out of 30 interactions between baseline treatment preferences and treatment type were found to be significant at the p < .05 level. All were in the predicted direction, with patients who showed a stronger preference for a treatment achieving better outcomes in that treatment compared with the alternative. However, pro-LICBT was a stronger predictor of outcomes than pro-PCC. The findings provide preliminary support that treatment preferences should be taken into account when providing interventions for patients with persistent sub-threshold and mild depression. It is recommended that further research analyses preferences for different treatment types as independent variables, and examines preferences for format of treatment (e.g. guided self-help vs. face-to-face). 相似文献
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139.
North American and global cultures in general—and the field of Couple and Family Therapy in particular—have made significant strides toward recognizing and validating LGBTQ identities and relationships. However, clinical assessment and conceptualization of queer couples still lack the complexity needed to encompass the issues involved in treatment. Existing literature provides clinicians a basic understanding of queer couples and the dynamics that make them unique from nonqueer couples. However, much of this knowledge has been normed on White middle‐class couples and has rarely included couples with transgender or bisexual members. This article invites clinicians and researchers to apply a feminist model of intersectionality to understand queer couples. Our proposed intersectional lens considers multiple axes of identity and power and their interrelationships (Crenshaw, 1989, 1991). We argue that intersectionality is important for understanding all identities, whether privileged or marginalized (Falicov, 2003). This application of the concept of intersectionality is unique in its relational focus, emphasizing how partners’ complex individual identities overlap with and intersect with one another. Additionally, this lens considers how the therapists’ and clients’ multidimensional identities intersect. Three case studies are presented to illustrate application of the intersectional lens. In each case, exploring the partners’ multiple social locations, their influences on one another, and the therapist's intersections of identity all proved critical to the direction of therapy. 相似文献
140.
Ricker C Lagos V Feldman N Hiyama S Fuentes S Kumar V Gonzalez K Palomares M Blazer K Lowstuter K MacDonald D Weitzel J 《Journal of genetic counseling》2006,15(6):505-514
Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina6 (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used 相似文献